Modified Indiana Pouch: Surgical technique and preliminary results

1997 ◽  
Vol 64 (2) ◽  
pp. 251-254
Author(s):  
G. Muto ◽  
M. Moroni ◽  
S. Leoni ◽  
E. Spatafora ◽  
F. Bardari
Keyword(s):  
Metabolic Acidosis ◽  
Surgical Technique ◽  
Acute Pyelonephritis ◽  
Operating Time ◽  
Reggio Emilia ◽  
Gastrointestinal Anastomosis ◽  
Preliminary Results ◽  
Indiana Pouch ◽  
Operative Complications

– Two modified continent Indiana Pouch techniques are presented, one of which using gastrointestinal anastomosis (GIA) staplers. The authors describe their experience with 88 patients who underwent the above operation at the Divisions of Urology in the Maria Vittoria Hospital of Turin and S. Maria Nuova Hospital of Reggio Emilia. Mean follow-up is 18 months (range 4-26). A total of 24 post-operative complications are described: 2 bowel obstructions, 4 strictures of the stoma, 3 parastomal hernias, 1 pouchitis and 1 acute pyelonephritis, 2 cases of incontinence, 2 of over-distension of the pouch, 5 ureteral obstructions and 4 cases of diarrhoea. Neither stones of the pouch nor metabolic acidosis were observed. Using GIA staplers for tailoring the pouch saves 120 minutes operating time for an additional cost of about 600 $.

scholarly journals Endoscopic treatment of suprasellar cysts without hydrocephalus

2016 ◽  
Vol 18 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Song-Bai Gui ◽  
Sheng-Yuan Yu ◽  
Lei Cao ◽  
Ji-wei Bai ◽  
Xin-Sheng Wang ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Success Rate ◽  
Patient Outcomes ◽  
Endoscopic Treatment ◽  
Foramen Of Monro ◽  
Image Guided ◽  
Operative Complications ◽  
Appropriate Therapy ◽  
Endoscopic Fenestration

OBJECTIVE At present, endoscopic treatment is advised as the first procedure in cases of suprasellar arachnoid cysts (SSCs) with hydrocephalus. However, the appropriate therapy for SSCs without hydrocephalus has not been fully determined yet because such cases are very rare and because it is usually difficult to perform the neuroendoscopic procedure in patients without ventriculomegaly given difficulties with ventricular cannulation and the narrow foramen of Monro. The purpose of this study was to find out the value of navigation-guided neuroendoscopic ventriculocystocisternostomy (VCC) for SSCs without lateral ventriculomegaly. METHODS Five consecutive patients with SSC without hydrocephalus were surgically treated using endoscopic fenestration (VCC) guided by navigation between March 2014 and November 2015. The surgical technique, success rate, and patient outcomes were assessed and compared with those from hydrocephalic patients managed in a similar fashion. RESULTS The small ventricles were successfully cannulated using navigational tracking, and the VCC was accomplished in all patients. There were no operative complications related to the endoscopic procedure. In all patients the SSC decreased in size and symptoms improved postoperatively (mean follow-up 10.4 months). CONCLUSIONS Endoscopic VCC can be performed as an effective, safe, and simple treatment option by using intraoperative image-based neuronavigation in SSC patients without hydrocephalus. The image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of hydrocephalus in patients with SSC may not be a contraindication to endoscopic treatment.

Our experience in orthotopic bladder substitution

1998 ◽  
Vol 65 (1) ◽  
pp. 180-184
Author(s):  
C. Del Boca ◽  
D. Colloi ◽  
C. Ferrari ◽  
M. Colecchia
Keyword(s):  
Quality Of Life ◽  
Surgical Technique ◽  
Patient Selection ◽  
Ileal Conduit ◽  
Operating Time ◽  
Orthotopic Neobladder ◽  
Rapid Preparation ◽  
Bladder Substitution

Research in the field of orthotopic neobladders springs from the need to improve their morphofunctional aspects and to simplify surgical procedures. The authors report their experience on a new method of orthotopic neobladder in 20 patients subjected to radical cystectomy for advanced bladder neoplasia between March 1991 and February 1996. The surgical technique consisted of preparing a reservoir with a simil Carney 2 type procedure modified by the authors using 45 cm of ileus, 30 cm of which are detubularised and reshaped into a spherical/ovoidal form with Poligya 75 staplers. The remaining segment was left intact for the ureteroileal anastomosis performed with the Wallace 1 procedure. This technique offers the following advantages: staplers enable rapid preparation of the neobladder, thus reducing operating time; the technique is easy to learn for urologists familiar with ureteroileostomy according to Wallace; an isoperistaltic segment of ileus for ureteral anastomosis reduces ureteral mobilisation and possibilities of reflux; reconversion into ileal conduit is easy in the event of reservoir failure or neoplastic urethral recurrence. The criteria for patient selection are given and the diagnostic follow-up algorithm done with biochemical, echographic, radiological and pressure studies. Particular attention was paid to the quality of life in relation to diurnal/nocturnal continence and micturitional interval. The authors conclude that this technique is surgically simple and rapid giving satisfactory clinical and urodynamic results.

scholarly journals What did we learn from our first arthroscopic Trillat procedures? Results, complications and failures in a series of 100 anterior shoulder stabilizations

2021 ◽  
Vol 9 (2_suppl) ◽  
pp. 2325967121S0000
Author(s):  
Ludovic Labattut ◽  
Thomas Chauvet ◽  
Romain Colombi ◽  
Emmanuel Baulot ◽  
Pierre Martz
Keyword(s):  
Surgical Technique ◽  
Ct Scan ◽  
Shoulder Instability ◽  
Muscle Tone ◽  
Operating Time ◽  
Functional Results ◽  
First Episode ◽  
Anterior Shoulder Instability ◽  
Standard Radiographs

Objectives: Arthroscopic adaptation of the Trillat procedure has become a part of the armamentarium for anterior shoulder instability. As the first team to have described a surgical technique, we present the results of our first 100 patients. Methods: This is a cohort study on a prospective database, descriptive of patients who had undergone surgery for chronic anterior shoulder instability between March 2011 the date our technique was developed, and October 2019. Patients were clinically and radiologically evaluated preoperatively (standard radiographs, CT scan) and postoperatively (standard radiographs) at 1, 3, 6 and 12 months and by CT scan 6 months postoperatively to evaluate the consolidation of the coracoid fracture and subscapularis muscle trophicity. Functional results were evaluated by Constant, SSV, Walch/Duplay and Rowe scores and recurrences of accidents due to instability and complications were collated. Results: 100 patients, mean follow-up of 25 months (6-96), mean age, 29 years (15-73), 71% sportspeople, mean age at first episode, 20 years (7-59), 20% hyperlaxity. 67% notches, 22% bony Bankart, 15% glenoid wear and 2% rotator cuff tear. The surgical technique was identical, there were 3 operators, average operating time was 50 min (26-145), 70% were ambulatory, there were 13 fractures and no conversion to an open technique. At the last follow-up there were 3 recurrences of luxation and 4 recurrences of subluxation and in 4 cases failure to recover muscle tone was noted. 95% of the sportspersons resumed their activity, 81% at the previous level. One year postoperatively, the Walsh-Duplay score was 88 (40-100) and the Rowe score was 92 (40-100). There were 4 cases of pseudoarthrosis, 3 of which were due to a technical defect, 2 coracoid fractures, 1 case of resolving sepsis and no neurological complications. There was no damage to the subscapularis. 97% of the patients were satisfied or very satisfied. Conclusion: This is the largest available series on the arthroscopic Trillat procedure. The results are identical to those in the preliminary series and as good as those for the reference techniques. Failures and complications were few and often the result of technical errors. The recovery of muscle tone in the limb on which surgery was performed seemed to influence the effectiveness of stabilization.

Arthroscopic-assisted focal resurfacing of the knee: surgical technique and preliminary results of 13 patients at 2 years follow-up

2010 ◽  
Vol 19 (5) ◽  
pp. 740-746 ◽  
Author(s):  
Maurilio Marcacci ◽  
Danilo Bruni ◽  
Stefano Zaffagnini ◽  
Francesco Iacono ◽  
Mirco Lo Presti ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Preliminary Results ◽  
Focal Resurfacing

scholarly journals Comparison of Bipolar Scissors and Bipolar Forceps in Tonsillectomy

2002 ◽  
Vol 81 (10) ◽  
pp. 714-717 ◽  
Author(s):  
Nitesh Patel ◽  
Paul Kirkland ◽  
Pavan Tandon ◽  
Terry Hung ◽  
Jeff Knight
Keyword(s):  
Surgical Technique ◽  
Telephone Survey ◽  
Intraoperative Complications ◽  
Operating Time ◽  
Bipolar Diathermy ◽  
Outpatient Procedure ◽  
Bipolar Scissors ◽  
A Prospective Study ◽  
New Surgical Technique

Bipolar diathermy scissors tonsillectomy is a relatively new surgical technique. We conducted a prospective study of 90 patients to compare this technique with bipolar forceps tonsillectomy. We found that the use of the bipolar scissors required significantly less operating time (mean: 3.03 min less) and allowed patients to resume eating solid food more rapidly (mean: 40.35 min earlier). Bipolar scissors tonsillectomy was safe, and there were no intraoperative complications or primary hemorrhages. A postoperative follow-up telephone survey revealed that patients who underwent scissors tonsillectomy experienced no more morbidity than did the forceps group during the first 2 weeks after surgery. We conclude that bipolar scissors tonsillectomy is a safe and rapid technique that can be used successfully as an outpatient procedure.

scholarly journals A comparative study of excision with primary closure versus Limberg flap in pilonidal sinus

2019 ◽  
Vol 6 (12) ◽  
pp. 4282
Author(s):  
Omesh Kumar Meena ◽  
Dheer Singh Kalwaniya ◽  
Satya V. Arya ◽  
Manikandan Kuppuswami ◽  
Jaspreet Singh Bajwa ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Pilonidal Disease ◽  
Operating Time ◽  
Pilonidal Sinus Disease ◽  
Limberg Flap ◽  
Flap Procedure ◽  
Operative Complications ◽  
Post Operative Complications

Background: The term ‘pilonidal sinus’ describes a condition found in the natal cleft overlying the coccyx which is treated by excision.Methods: This study is a prospective study held in Department of general surgery, Safdarjung Hospital, New Delhi from October 2014 to April 2016 on 60 patients out of which 30 were controls (excision with primary closure) and 30 were taken as case (Limberg flap). Post-operative follow up was done till 6 months and complications were noted. The data was tabulated and SPSS version 17 was used for statistics.Results: Pilonidal sinus disease is common in age group 20 years and above and twice more common in males than females. Although operating time in Limberg flap is little more as compared to primary closure but insignificant. The post-operative pain in the long term follow up is less in the Limberg flap procedure, although in the initial post-operative period it is slightly higher as compared to primary closure. In Limberg flap procedure, post-operative complications like stitch line infection, seroma formation, wound dehiscence are low as compared to primary closure. Limberg flap require 2.27±0.52 days hospital stay as compared to 3.57±1.43 days in primary closure due to less post-operative complications. Recurrence rate is 3.33% in Limberg flap as compared to 26.67% in primary closure group.Conclusions: We recommend the Limberg flap method for primary pilonidal disease with low morbidity rates over primary closure.

Pelvic Organ Prolapse Repair with Mesh: Description of Surgical Technique Using the Surelift® Anterior Repair System

2020 ◽  
pp. 1-6
Author(s):  
Laura Mateu-Arrom ◽  
Cristina Gutiérrez-Ruiz ◽  
Joan Palou Redorta ◽  
Carlos Errando-Smet
Keyword(s):  
Pelvic Organ Prolapse ◽  
Surgical Technique ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Repair System ◽  
Mesh Exposure ◽  
Anterior Repair ◽  
Preliminary Results ◽  
Pop Repair

<b><i>Introduction:</i></b> Although the use of transvaginal mesh (TVM) in the repair of pelvic organ prolapse (POP) has been restricted, there are still some cases in which TVM may be the most appropriate approach. The TVM Surelift® anterior repair surgical technique has not been described previously. <b><i>Objective:</i></b> The aim of this study was to describe the surgical technique and to report our preliminary results regarding efficacy and complications. <b><i>Methods:</i></b> A step-by-step description of surgical technique is presented. A descriptive retrospective analysis was performed to evaluate our preliminary results in 17 women who underwent POP repair using the Surelift® anterior repair system in our department between 2014 and 2017. TVM was offered to patients with symptomatic apical (primary or recurrent) or recurrent anterior POP stage ≥2. POP recurrence was classified as asymptomatic anatomic or symptomatic. Patients rated satisfaction with surgery on a scale from 0 to 10. Complications during follow-up were classified according to the International Urogynecological Association/International Continence Society recommendations. <b><i>Results:</i></b> Median (IQR) follow-up was 19.9 months (24.8). Two (11.8%) anatomic recurrences were identified, both symptomatic, but neither required further surgery. No cases of pelvic pain, dyspareunia, voiding, or defecatory dysfunction were detected. Two (11.8%) patients presented a &#x3c;1-cm vaginal mesh exposure (2AaT3S2) requiring partial mesh removal through a vaginal approach. At the end of follow-up, median satisfaction (IQR) with the surgery was 9 (3.1). <b><i>Conclusion:</i></b> The Surelift® anterior repair system is effective in correcting apical or recurrent anterior POP, with a high patient satisfaction rate. Complications after this surgery are infrequent and are mostly related to vaginal mesh exposure.

1848: Revolix 70 Watt 2 Micron Continuous Wave Laser Vaporesection of the Prostate. Preliminary Results After a One Year Follow-Up

2007 ◽  
Vol 177 (4S) ◽  
pp. 614-614
Author(s):  
Thorsten Bach ◽  
Thomas R.W. Herrmann ◽  
Roman Ganzer ◽  
Andreas J. Gross
Keyword(s):  
Continuous Wave ◽  
Continuous Wave Laser ◽  
Preliminary Results ◽  
Wave Laser ◽  
One Year

Role of Closed Mitral Commissurotomy for Mitral Stenosis: Mid- and Long-term Surgical Outcome of 36 Patients

2005 ◽  
Vol 8 (1) ◽  
pp. 55 ◽  
Author(s):  
Azman Ates ◽  
Yahya �nl� ◽  
Ibrahim Yekeler ◽  
Bilgehan Erkut ◽  
Yavuz Balci ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Stenosis ◽  
Operating Time ◽  
Term Survival ◽  
Long Term Outcome ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

Purpose: To evaluate long-term survival and valve-related complications as well as prognostic factors for mid- and long-term outcome after closed mitral commissurotomy, covering a follow-up period of 14 years. Material and Methods: Between 1989 and 2003, 36 patients (28 women and 8 men, mean age 28.8 6.1 years) underwent closed mitral commissurotomy at our institution. The majority of patients were in New York Heart Association (NYHA) functional class IIB, III, or IV. Indication for closed mitral commissurotomy was mitral stenosis. Closed mitral commissurotomy was undertaken with a Tubbs dilator in all cases. Median operating time was 2.5 hours 30 minutes. Results: After closed mitral commissurotomy, the mitral valve areas of these patients were increased substantially, from 0.9 to 2.11 cm2. No further operation after initial closed mitral commissurotomy was required in 86% of the patients (n = 31), and NYHA functional classification was improved in 94% (n = 34). Postoperative complications and operative mortality were not seen. Follow-up revealed restenosis in 8.5% (n = 3) of the patients, minimal mitral regurgitation in 22.2% (n = 8), and grade 3 mitral regurgitation in 5.5% (n = 2) patients. No early mortality occurred in closed mitral commissurotomy patients. Reoperation was essential for 5 patients following closed mitral commissurotomy; 2 procedures were open mitral commissurotomies and 3 were mitral valve replacements. No mortality occurred in these patients. Conclusions: The mitral valve area was significantly increased and the mean mitral valve gradient was reduced in patients after closed mitral commissurotomy. Closed mitral commissurotomy is a safe alternative to open mitral commissurotomy and balloon mitral commissurotomy in selected patients.

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